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At least 1,621 records · Page 90Linked to original sources

[Effect of jiang-zhi jian-fei yao on gastro-intestinal movement and adipose cell of abdominal wall].

Jiang-Zhi Jian-Fei Yao (JZJFY), an obesity-reducing drug, its active principle is the refined Rhubarb, the mechanism of its obesity-reducing effect was studied. JZJFY was injected intragastrically. The results showed that there was no significant increased of body weight, but a reduction of food intake, prolongation of stomach evacuation time, acceleration of intestinal movement 6 days after medication in rats. Meanwhile the adipose cells in abdominal wall were varied in size, and with Sudan III stain the color of adipose cells was light. Authors suggest that the obesity-reducing effect of JZJFY was relevant to above-mentioned changes.

Adipocytes↗

[The so-called Spigelian hernia--a rare lateral hernia of the abdominal wall].

A patient with Spigelian hernia is presented and the main pathological and clinical features are discussed. Its true incidence is probably greater than the small number of patients reported in the literature due to failure to recognize the clinical picture. A hernia through a defect in the Spigelian fascia (aponeurosis of the transverse muscle of the abdomen) is called Spigelian hernia. The semilunar (Spigelian) line is defined as the line forming the transition from muscle to aponeurosis in the transverse muscle of the abdominal wall. It is a lateral convey line between the costal arch and the pubic tubercle. The part of the aponeurosis that lies between this semilunar line and the lateral edge of the rectus muscle is called the "Spigelian fascia" (correct: Spigelian aponeurosis). The hernia is located intramurally because the hernia is covered by the aponeurosis of the external oblique aponeurosis, so that both, the hernial sac and the orifice, can often not be detected by palpation. Clinical symptoms are not characteristic but most patients have a distinct tender point above the hernial orifice.

Abdominal Muscles↗

Bursting strength evaluation. Comparison of 0-Prolene sutures and endoscopic staples in an experimental prosthetic patch repair of abdominal wall defect.

Recently, titanium staples have been designed to stabilize a small prosthetic mesh used for laparoscopic herniorrhaphy. Unlike the giant prosthesis employed by Stoppa, the small mesh must be fixed to the surrounding musculo-aponeurotic defect. The strength of these titanium staples has never been evaluated and was compared to 0-Prolene sutures. In an ex vivo study, we evaluated the maximal stress (bursting strength [BS]) a repair performed with 0-Prolene sutures or staples can bear. Bilateral abdominal-wall defects were created in 16 piglets. A Prolene mesh was fixed preperitoneally on one side of the abdomen with 0-Prolene sutures and on the other side with the Endopath EMS stapler or the Endo Hernia stapler. The mean BS of meshes attached with 0-Prolene was 1,461.7 mmHg. The mean BS of meshes fixed with Endopath EMS staples was 885.5 mmHg and that of meshes fixed with Endo Hernia staples was 665.2 mmHg. A repair with 0-Prolene sutures is stronger (P < 0.05) than one with staples (Endopath EMS or Endo Hernia). Also, repair with an Endopath EMS stapler has a significantly higher BS (P < 0.05) than one with the Endo Hernia stapler. In the second part of the study, evaluation of the longitudinal tensile strength also showed that 0-Prolene sutures are stronger (P < 0.05) than staples. Endopath EMS staples are stronger (P < 0.05) than Endo Hernia staples.

Abdominal Muscles↗

Abdominal wall and foot reconstruction after extensive desmoid tumor resection with free tissue transfer.

BACKGROUND: Desmoid tumors are rare connective tissue tumors, also referred to as deep, aggressive fibromatosis. Although histologically benign, they show an invasive growth behavior and have a high local recurrence rate. METHODS: The treatment of choice is surgical resection with wide negative margins, while the use of radiotherapy remains controversial. Wide resection of greater desmoid tumors may result in considerable defects and functional impairment. Few papers discuss different options for defect coverage after desmoid tumor resection. Two cases of extensive desmoid tumors, one at the trunk, one at the foot, both with compromised wound margins due to multiple previous surgeries, are presented. To achieve a stable and functional soft tissue cover, the defects were treated with microvascular soft tissue transfer (one free latissimus dorsi, one free radial forearm flap). RESULTS: Both flaps healed uneventfully and patients regained full function of the abdominal wall and foot, respectively. CONCLUSIONS: The presented cases demonstrate the efficacy of free flap coverage as an ultimate therapeutic option in selected cases of critical defects after extra-abdominal desmoid tumor resection. Furthermore, free flaps provide a well vascularized ground for adjuvant radiotherapy.

Adult↗

[Modifications in the abdominal wall after prostheses implant in guinea pigs. Experimental preliminary study].

The treatment of giant incisional hernias is often not possible without the use of alloplastic materials (prostheses, meshes). Some of the modern prostheses seem to be quite "biocompatible" from the chemical point of view, but, the manner of using them is associated with certain complications (infection, seroma formation, intestinal obstruction, digestive fistula and failure of the repair). This preliminary experimental study on Guinea pigs had as a purpose the evaluation of the prostheses incorporation in the abdominal wall, the appearance of specific complications and the need of the biomaterial fixation. The macroscopic and microscopic study used 59 Guinea pigs, utilizing polypropylene (Marlex) and polyester (Mersilene and Plastex) prostheses, implanted pre-peritoneal and intraperitoneal, with or without fixation. The lack of incorporation of the prostheses was observed especially with the Plastex mesh (7 cases). Intestinal adhesions have been the rule after intraperitoneal implant of the prostheses; we registered a case of intestinal obstruction and a case of digestive fistula. Concluding, it is recommended the utilization of quality prostheses, especially polypropylene (Marlex) and no longer use of the Romanian polyester mesh (Plastex) which has obvious "biocompatible" problems. The intraperitoneal implant of the prostheses is not indicated. Adequate anchoring af the biomaterials prevents the subsequent migration.

Abdominal Muscles↗

Actinomycotic tumor of the abdominal wall.

We present the case of an elderly patient with abdominal pain, weight loss, and subjective fever in whom a magnetic resonance imaging study revealed a perihepatic abscess without invasion. After drainage, anaerobic cultures yielded Actinomycosis israelii. We discuss Actinomycosis species, with an emphasis on its pathology and multiple presentations.

Abdominal Wall↗

The Risk of Anterior Abdominal Wall Adhesions in Patients with Previous Umbilical Hernia Repair

The incidence of umbilical hernia may be increased in certain populations during infancy. Many procedures to repair such defects are thus performed during early childhood. Patients may present for adult surgery with minimal or no recollection of these surgeries and with only a small infra-umbilical incision which appears remarkably similar to an incision for laparoscopy. We proposed to evaluate the risk of adhesions to the area of the umbilicus and anterior abdominal wall in patients presenting for laparoscopic surgery. Eight patients with documentable umbilical hernia repair comprise this study. One patient had undergone two procedures. To best evaluate the umbilicus, initial trocar insertion was made in the left upper quadrant, 2 cm below the costal margin in the mid-clavicular line. Findings demonstrated significant bowel and omental adhesions to the area of the umbilicus in all but one patient. Interestingly, one patient had previously undergone an unsuccessful attempt at Veress needle placement and open laparoscopy. This patient had massive bowel adhesions to the entire umbilical region. In all but the one case, trocar or Veress needle insertion would have likely caused significant tissue or visceral injury. No complications occurred in this series. In conclusion, patients with previous umbilical hernia repair may be at higher risk for adhesive disease to this region. Appropriate bowel preparation prior to surgery and site selection for trocar entry may aid in decreasing the risk of visceral injury.

Journal Article↗

Organ culture in 3-dimensional matrix: in vitro model for evaluating biological compliance of synthetic meshes for abdominal wall repair.

A new in vitro method to evaluate the early critical interactions between synthetic prosthetic materials and growing tissues is reported. The correct spatial organization and proper cell to cell interaction required to mimic the in vivo environment was obtained in a 3-dimensional (3-D) embryo organ culture. The clot formed by plasma and chick-embryo extract provided a natural 3-D extracellular matrix that was able to support the growth and differentiation of intestinal tissue dissected from 12-day-old chick embryos. Different materials used for the repair of abdominal wall defects were taken as standards; all the prosthetic materials were devoid of any evident cytotoxic potential over a 10-day culture period, so they did not interfere with the organogenesis process. A polyglactin mesh (Vicryl) was fully incorporated into the growing tissue, but early signs of its degradation were detectable. The biologically inert materials polyethylene terephthalate (Mersilene) and polypropylene (Marlex, Prolene, and Herniamesh) retained their structural integrity when incubated with cultured tissue at 37 degrees C, and they did not hinder cellular proliferation or fibroblast migration. However, the outgrowth behavior was very different while the connective tissue invaded the interstices of the polyethylene terephthalate mesh; the explants and the migrating cells were repelled by hydrophobic polypropylene meshes. These findings are in agreement with other reported results in in vivo studies. Therefore, this method can be considered as reliable and predictable for the evaluation of biopolymers.

Abdominal Muscles↗

[Suture technics for the abdominal wall after midline laparotomy].

During the last 10 years 268 laparotomies by a midline incision were performed. A high incidence of seromas, fistulas caused by suturing material and wound ruptures were observed. After finding only a small number of publications in the veterinary medicine about wound healing disturbances an analysis of the human medical literature was done. This induced the change of our surgical procedure and suturing technique: The midline incision and surgical management during the laparotomies in 14 horses suffering from colic were performed by a minimized trauma. The abdominal wall was closed layer by layer in the following manner: peritoneum by a running suture of catgut metric 5, linea alba by Sultan single sutures of polyglycolic acid material metric 5 (12 cases) or of polydioxanone metric 4 (2 cases), subcutaneous layer by a running suture of polyglycolic acid material metric 4, skin by single sutures of monofilamentous synthetic material metric 2. Thus, no complications in wound healing were observed in these 14 horses. Therefore, we recommend to prove the described surgical and suturing procedure by a larger number of horses undergoing a laparotomy by a midline incision.

Animals↗

Abdominal wall closure after selective aponeurotic incision and undermining.

The tension required to pull the anterior and the posterior rectus sheaths toward the midline was studied in 20 fresh cadavers at two levels: 3 cm above and 2 cm below the umbilicus. The quotient of the force used to mobilize the aponeurotic site to the midline and its resulting displacement was called the traction index. These indices were compared in three situations: (1) prior to any aponeurotic undermining, (2) after the incision of the anterior rectus sheath and the undermining of the rectus muscle from its posterior sheath, and (3) after additionally releasing and undermining the external oblique muscle. A significant decrease in aponeurotic resistance was observed after each dissection. The anterior sheath showed higher resistance to traction compared with the posterior sheath on both levels. No statistical difference was noted in the comparison of the values of the aponeurosis above and below the umbilicus. These results suggest that these procedures are effective in assisting in the closure of abdominal wall defects because these maneuvers decrease substantially the tension required for advancement of the aponeurotic edges.

Abdominal Muscles↗